Metabolic Syndrome in Type 1 Diabetes

Metabolic Syndrome in Type 1 Diabetes Association with diabetic nephropathy and glycemic control (the FinnDiane study) Lena M. Thorn , MD 1 2 , Carol Forsblom , MD, DMSC 1 2 , Johan Fagerudd , MD, DMSC 1 2 , Merlin C. Thomas , MD, PHD 3 , Kim Pettersson-Fernholm , MD, DMSC 1 2 , Markku Saraheimo , MD 1 2 , Johan Wadén , MD 1 2 , Mats Rönnback , MD 1 2 , Milla Rosengård-Bärlund , MD 1 2 , Clas-Göran af Björkesten , MD 1 2 , Marja-Riitta Taskinen , MD, DMSC 4 , Per-Henrik Groop , MD, DMSC 1 2 and on behalf of the FinnDiane Study Group 1 Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland 2 Department of Medicine, Division of Nephrology, Helsinki University Hospital, Helsinki, Finland 3 Baker Research Institute, Melbourne, Australia 4 Department of Medicine, Division of Cardiology, Helsinki University Hospital, Helsinki, Finland Address correspondence and reprint requests to Per-Henrik Groop, MD, DMSc, Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, POB 63, FIN-00014, Helsinki, Finland. E-mail: per-henrik.groop{at}helsinki.fi Abstract OBJECTIVE —The aim of this study was to estimate the prevalence of the metabolic syndrome in Finnish type 1 diabetic patients and to assess whether it is associated with diabetic nephropathy or poor glycemic control. RESEARCH DESIGN AND METHODS —In all, 2,415 type 1 diabetic patients (51% men, mean age 37 years, duration of diabetes 22 years) participating in the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) study were included. Metabolic syndrome was defined according to the National Cholesterol Education Program diagnostic criteria. Patients were classified as having normal albumin excretion rate (AER) ( n = 1,261), microalbuminuria ( n = 326), macroalbuminuria ( n = 383), or end-stage renal disease (ESRD) ( n = 164). Glycemic control was classified as good (HbA 1c 9.0%). Creatinine clearance was estimated with the Cockcroft-Gault formula. RESULTS —The overall prevalence of metabolic syndrome was 38% in men and 40% in women. The prevalence was 28% in those with normal AER, 44% in microalbuminuric patients, 62% in macroalbuminuric patients, and 68% in patients with ESRD ( P < 0.001). Patients with metabolic syndrome had a 3.75-fold odds ratio for diabetic nephropathy (95% CI 2.89–4.85), and all of the separate components of the syndrome were independently associated with diabetic nephropathy. The prevale